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Burning issues.

Burning issues.

Acidity is a huge topic in dentistry, but often having acid reflux is grossly overlooked. Acid reflux is the backward flow of stomach acids into the esophagus or the food tube. GERD (gastroesophageal reflux disease) is said to be a more severe form of acid reflux. Having acid reflux can cause heartburn, irritations, a sour taste in the back of the throat, and much more. Because I am not a professional on the matter, I do not think I am the best person to explain the causes, symptoms, and treatments for acid reflux. I am, however, an expert on oral conditions pertaining to patients.

As stated before, acid reflux causes stomach acid to regurgitate into the tube connecting the mouth to the stomach. Healthline.com stated that approximately 60% of adults experience some sort or acid reflux! That is a lot of acid to worry about! The concern in dentistry is that stomach acid can (and does) very easily erode tooth enamel.

The exposure to stomach acid in the mouth can cause erosion of tooth enamel, tissue irritations such as sores or inflammation, and possible fractures of crowns. Stomach acid is normally in the range of 1.2- 3.5 (VERY acidic), while the oral cavity averages around 6.2-7.5 (neutral). Erosion of tooth enamel occurs around a pH of 5.7.

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The white arrows are pointing to all of the areas of acid erosion on the tongue side of this person’s teeth! That is a lot of wear!

One of the many purposes of saliva is to rinse the mouth of any irregularity such as acids (and bases). The process of remineralization from saliva takes about 20 minutes after exposure. This means, once your mouth is exposed to acids through eating, drinking, or acid reflux, it takes the saliva (without the help of mouth rinses) about 20 minutes to bring the acidity level in the mouth back to a non-damaging level. Unfortunately, when the acids from the stomach flourish for long periods of time the saliva is unable to neutralize the acid and erosion can occur.

Why is erosion a big deal? With acid  (or any type of) erosion, the teeth become thin, brittle, sensitive, and unprotected from the external environment. Erosion removes the strong enamel layer of the teeth and exposes the softer dentin layer that is easily broken down. The dentin layer exposes tiny ‘pores’ in the teeth that make changes in the oral environment sensitive. This is why some people experience temperature sensitivity. The ‘pores’ of the teeth are similar to very tiny tunnels that lead to the nerve of the tooth causing ‘flare-ups’ when drinking cold water.

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The ‘Enamel’ is the strong protective layer of the teeth, the ‘Dentin’ is the softer layer below the enamel. This picture shows a damaged tooth with the two layers exposed.

With the enamel layer being depleted, the integrity or strength of the teeth is very small. I will often see patients that have broken, cracked or painful teeth due to having ‘thin’ enamel. With the thinner and weaker tooth structure, eating becomes complicated. Taking a bite out of firm foods such as apples, carrots, or some steaks could cause fractures to the teeth. Once breakage occurs dental treatments such as fillings, crowns, implants, and veneers are required for optimal comfort and to prevent further damage. Thin enamel also causes yellowing or other discoloration of the teeth!

Thankfully, there are things you can do to help protect the teeth! I recommend always rinsing with a plain warm water rinse after eating and drinking anything. The water will aid saliva in the neutralizing of the mouth and it is VERY inexpensive. There are also numerous products I recommend using if you have a ‘high acidity’ diet. “CloSYS” is my number one recommended mouth rinse to help reduce the cavity risk and decrease acid levels in the mouth. I have numerous patients that have great results with this product, and it is relatively inexpensive for being a specialty rinse. I also recommend ACT Alcohol Free Anticavity Fluoride Rinse. ACT rinse has great remineralizing properties. My final recommendation would be to discuss your acid reflux with your primary care physician. Fortunately, there are quite a few solutions to help reduce the symptoms associated with acid reflux!

As always, I welcome ANY of your dental questions! Hopefully, this information and all of these recommendations can help! As always, If you have any questions or concerns don’t be afraid to post a comment or send an email! I am always happy to answer your burning dental questions. Have a great day, and don’t forget to smile today!

-DentalBritt

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